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297 Cards in this Set
- Front
- Back
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Motor Control Systems influence
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1. Tells the LMN what to do
2. LMN to fire or not to |
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Two Major Motor Systems and Function
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Pyramidal: Initiated, voluntary skeletal muscle activity
Extrapyramidal: Involuntary skeletal muscle activity |
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Supplemental Motor Areas
(Pyramidal System) are located in what lobe and areas? |
-Frontal Lobe
-Anterior to Primary Motor Cortex -Superior to PreMotor Cortex |
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Supplemental Motor Area finessed movements play what three roles?
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- Important for initiation of movement
- Orientation of the eyes and head - Planning sequential and bi-manual movements |
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Supplemental Motor Area goes to...
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- Interacts with pre-central gyrus (Pre-motor Cortex)
- Sends UMN to CN motor Nuclei - Ventral Horns of spinal Cord where UMN synapse with LMN |
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Premotor Area is part of what system?
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Pyramidal system
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Premotor Area is found in what lobe of the brain?
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Frontal Lobe
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Is the Broca's Area anterior or posterior to the pre-central gyrus?
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Anterior
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Functionally, the pre-motor area is an association area that controls
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Trunk, Pelvic, and Pectoral Girdle Musculature
(Helps with changing your posture) |
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T or F The pre-motor area is involved with anticipatory postural control and adjustments
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True
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What area interacts with pre-central gyrus, as well as sending UMN to the CN nuclei in the brainstem and sends UMN to ventral horns
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Pre-motor Area
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Broca's Area is part of what system
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Pyramidal System (voluntary)
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Broca's area is found in what lobe of the brain?
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Frontal Lobe
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Is Broca's area anterior or posterior to the pre-central gyrus?
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Anterior
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Functionally the Broca's area is an association area that functions as...
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Primary function is to instigate speech (Tell the muscles what to say)
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What are the two corticofugal motor tracts?
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- Corticospinal Tract
- Corticobulbar Tract |
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Is the corticospinal tract part of the pyramidal or extrapyramidal system?
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Pyramidal (voluntary skeletal)
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The cell bodies of the corticospinal tract are found in which gyrus and lobe of the brain?
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Pre-central Gyrus / Frontal Lobe
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What cranial nerves do not have motor input?
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CN I, II, VIII
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What two Cranial Nerves have unilateral projection patterns?
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CN VII & XII
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What are the two motor functions CNIII?
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1. Innervates extrinisc eye muscles & levator palpebrae superioris
2. Innervates iris and ciliary body |
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What complex contains cell bodies of LMN in tegmentum of the midbrain for CNIII for it's function of innervating extrinsic eye muscles and levator palpebrae superioris?
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Oculomotor Nuclear Complex
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The preganglionic parasympathetic neurons that innervate the iris and ciliary body (CNIII) begin in what nucleus and location?
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Edinger-Westphal Nucleus
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The synapse between the pre and post ganglionic parasympathetic neurons that innervates the iris and ciliary bodies (CNIII) are located in what ganglia?
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Ciliary Ganglia
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Does the Trochlear Nerve (IV) receive bilateral or unilateral input from UMN in the corticobulbar tracts?
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Bilateral input
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What muscle(s) does the Trochlear nerve (CN IV) innervate and where in the tegmentum of the midbrain are the cell bodies of LMN located?
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- Superior Oblique Extrinsic Eye Muscle
- Trochlear Motor Nucleus |
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What cranial nerve innervates the superior rectus, medial rectus, inferior rectus, and inferior oblique (extrinsic) muscles?
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Oculomotor Nerve (III)
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The muscles of mastication (medial & lateral ptyergoid, masseter, and temporalis muscles) are innervated by what cranial nerve?
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Trigeminal Nerve (V)
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Does the Trigeminal Nerve (V) receive input bilaterally or unilaterally from UMN in the corticobulbar tract?
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Bilateral
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In what nucleus are the cell bodies of the LMN of CN IV, tegmentum of the midbrain?
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Trochlear Motor Nucleus
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Motor nucleus of V contains cell bodies of LMN located in what area?
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Tegmentum of the Pons
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Where does the Trigeminal Nerve decussate?
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Pons at the motor nucleus of V
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What muscle does the Abducens nerve innervate?
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Lateral Rectus Extrinsic Eye Muscles
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Does the Abducens nerve receive bilateral or unilateral input from UMN in the corticobulbar tract?
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Bilateral
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Name the nucleus and where are the cell bodies of the LMN of CN VI are located?
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Abducens Motor Nucleus in the tegmentum of the Pons
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What are the 2 motor functions of the Facial Nerve?
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1. Innervates the muscles of facial expression.
2. Innervates the submandibular, sublingual, and lacrimal glands (parasympathetic function) |
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The Facial Nerve is divided into upper and lower portions in the corticobulbar tract. Is the upper bilateral or unilateral input? Lower?
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Upper - Bilateral input
Lower - Unilateral input |
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Facial Motor Nucleus contains what and is located where?
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Facial Motor Nucleus contains cell bodies of the LMN of the CN VII and located in the tegmentum of Pons
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What nucleus located in the tegmentum of the medulla will you find preganglionic parasympatheric neurons for CN VII?
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Salivatory Nuclei
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Regarding CN VII, where due the postganglionic parasympathetic neurons and preganglionic parasympathetic neurons synapse?
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Submandibular and Pterygopalatine Ganglia
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What are the 2 motor functions of CN IX?
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1. Innervates the stylopharyngeus muscle of pharynx
2. Innervates parotid gland (parasympathetic) |
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Where are the cell bodies of LMN for the glossopharyngeal nerve found and name of nucleus?
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Found in tegmentum of Medulla in the nucleus called Nucleus Ambiguous
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Does CN IX have bilateral or unilateral input from the corticobulbar tract?
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Bilateral
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Is the CN IX that innervates the parotid gland involved with the corticobulbar tract?
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No
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CN IX innervation of the parotid gland has preganglionic parasympathetic neurons found in what nucleus and where?
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Salivatory Nuclei in the tegmentum of the Medulla
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What synapses in the Otic Ganglia in the neck?
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Pre and Post Ganglionic Parasympathetic Neurons of CN IX
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What are the two motor functions of the Vagus Nerve?
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1. Innervates the muscles of the larynx, pharynx, and soft palate
2. Innervates the viscera of the thorax, abdomen, and pelvis |
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Does CN X input from the corticobulbar tract give input bilaterally or unilaterally?
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Bilaterally
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The Nucleus Ambiguous contains cell bodies of LMN in the tegmentun of the Medulla for what CN?
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CN IX & XI
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Where are the Vagus Nerve preganglionic parasympathetic neurons located and name of nucleus?
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Dorsal Motor Nucleus in the tegmentum of Medulla
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Where do CN X pre and post ganglionic parasympathetic neurons synapse?
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Numerous Ganglia
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The Spinal Accessory Nerve receives bilateral input from what tract?
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Corticobulbar Tract
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LMN for CN XI begin in two separate nuclei?
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- Spinal Motor Nucleus (Cervical Portion)
- Nucleus Ambiguous (Cranial Portion) |
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The Spinal Motor Nuclei are located in what area?
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Rostral Cervical Regions of Spinal Cord
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The Nucleus Ambiguous Nuclei are located in what area?
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Tegmentum of the Medulla
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The Cervical portion of CN XI innervates what muscles?
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SCM & Trapezius
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The Cranial portion of CN XI innervates what muscles?
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Intrinsic Laryngeal Muscles
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Does the Hypoglossal Nerve receive input from corticobulbar tract bilaterally or unilaterally?
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Unilaterally
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Hypoglossal Nerve cell bodies of LMN are found in what nucleus and where?
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Hypoglossal Motor Nucleus in the Tegmentum of Medulla
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What are the four modulatory Descending Motor Tracts?
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1. Rubrospinal Tract
2. Tectospinal Tract 3. Vestibulospinal Tract 4. Reticulospinal Tract |
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What does the Modulatory Descending Motor Tracts due to subserve the corticospinal tract?
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The tracts refine and finesse the activity of LMN receiving input from the UMN
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What nucleus contains the cell bodies of UMN for the Rubrospinal Tract?
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Red Nucleus of the Midbrain
(Decussates here) |
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Where does the Rubrospinal Tract terminate?
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Ventral Horn of the Spinal Cord
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Does the Rubrospinal Tract excite or inhibit flexor activity? Extensor activity?
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Flexor Activity - Excite
Extensor Activity - Inhibit |
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What nucleus contains the cell bodies of UMN of the Tectospinal Tract?
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Superior Colliculus of the Midbrain (Decussates)
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Where does the Tectospinal Tract terminate?
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Ventral Horns of the Upper Cervical Spinal Cord
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True or False Tectospinal Tract causes reflex postural movements of the head, neck, and upper extremities in response to visual stimulus?
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True
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What nucleus and where do the cell bodies of the UMN originate for the Vestibulospinal Tract?
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Vestibular Nuclei in the Tegmentum of Pons (No Decussation)
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Where does the Vestibulospinal Tract terminate?
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Ventral Horn of the Spinal Cord
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What does the Vestibulospinal Tract do?
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Involved in "righting reflexes"
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The Reticulospinal Tract has cell bodies of UMN in what nuclei located in the ?
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Multiple Reticular Nuclei in the brainstem
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Does the Reticulospinal Tract have ipsilateral or contralateral function?
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Ipsilateral
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Does the Reticulospinal Tract excite or inhibit extensor activity? Flexor activity?
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Extensor Activity - Excites
Flexor Activity - Inhibits |
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True or False
Damage can occur anywhere along the Corticospinal Pathways? |
True
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What are the six classical signs of UMN damage in relation to the Corticofugal Tracts?
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1. Paresis
2. Paralysis 3. Exaggerated DTR: Hyperreflexia 4. Clonus 5. Spastic Paralysis 6. Hypertonia |
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UMN damage causing muscle weakness because skeletal muscles are receiving less input.
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Paresis
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UMN damage causing loss of movement; large range of loss because of less input; can mean loss of function.
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Paralysis
(UMN Paralysis) |
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UMN damage causing simple reflex arcs to be more active.
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Exaggerated DTR: Hyperreflexia
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UMN damage causing spasms with alterations of contractions and relaxation in rapid succession of antagonistic and agonistic muscles (hyperreflexia of spinal reflexes)
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Clonus
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UMN damage characterized by involuntary contraction of one ore more muscles w/loss of function. (Hallmark of UMN Lesion)
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Spastic Paralysis
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UMN caused by an increase of muscle tone.
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Hypertonia
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True or False
The corticospinal tract has ipsilateral effects before decussation and contralateral effects after the decussation. |
False
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True or False
Damage to the UMN causes the LMN to not get supraspinal instruction via the corticospinal tract not influencing the activity) |
True
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Name the test that runs an object up the lateral side of the foot testing for UMN lesion.
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Babinski test
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What will the patient do if have a Normal Babinski?
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Toes will plantarflex
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What will the patient do if have a Positive Babinski?
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Toes will dorsiflex and the great toe fans
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What are the six classical signs of LMN damage in the corticofugal motor tracts.
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1. Paresis
2. Flaccid Paralysis 3. Hypotonia 4. Decreased or Absent DTR 5. Fibrillations/Fasciculations 6. Atrophy |
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What cranial nerves are involved with LMN Paralysis?
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CN III, IV, V, VI, VII, IX, X, XI, XII - always ipsilateral
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Can LMN be alpha, gamma, or both motor neurons?
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Both
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Alpha or gamma motor neurons can be found in?
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1. Motor Nuclei of CN w/motor function
2. Ventral Horns of the Spinal Cord |
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LMN damamge can cause weakness, not innervating skeletal muscles resulting in a dramatic weakness.
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Paresis
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LMN damage causes total loss of muscle tone with resultant loss of function
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Flaccid Paralysis
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LMN damage causes decreased muscle tone because its lost the source that makes the muscle contract
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Hypotonia
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LMN damage causes wiped out LMN part of the reflex are affecting deep tendon reflexes.
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Decreased or absent DTR
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LMN damage causes reduction in size of skeletal muscle as a result of decreased tone (decreased actin and myosin fibers)
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Atrophy
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Can you get atrophy with UMN damage in the corticofugal motor tract?
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No, Only in LMN because with UMN damage the muscle cells are still contracting but it is spastic
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LMN damage causes spontaneous activity of skeletal muscle, physiological response not neurological.
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Fibrillations/Fasciculations
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Will symptoms with LMN damage in the corticofugal motor tract always be ipsilateral or contralateral and why?
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Ipsilateral, there is no decussating therefore it will always be ipsilateral
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What 5 categories do responses of LMN damage fall into?
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1. Spinal reflex responses
2. Rhythmic patterned movements 3. Become central pattern generators (CPG) 4. Recicprocal inhibitory neural circuits 5. Cell level |
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True or False
Rhythmic patterned movements are predictable involuntary movements involved with specific motor activities that can be hardwired from birth or developed through life. |
True
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When movements become central pattern generators (CPG) are they voluntary or involuntary movements?
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Involuntary movements
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Where are CPGs set up and remembered in?
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1. Basal Ganglia
2. Spinal Cord 3. Brainstem 4. Cerebellum (the most) |
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True or False
Reciprocal inhibitory neural circuts are NOT the physiological substrates for rhythmogeneisis in CPG systems. |
False - They are
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On a cellular level do membranes of the neurons involved with CPGs have NMDa receptors which bind with glutamate?
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Yes, adds a rhythmic characteristic to the membranes
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Spinal cord reflexes are segmental in nature and may involve one or more segments at a time. Does this cause communcation between the segments?
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Yes, it's how one segment knows what another one is doing.
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Where are spinal cord reflexes that involve propriospinal loops/circuits?
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Gray Matter
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What are the two tracts in regards to Spinal Cord Reflexes that modulate supraspinal influences?
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- Rubrospinal Tract
- Reticulospinal Tract |
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Rubrospinal tract modifies UMN system and is biased toward ________activity.
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flexor
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Reticulospinal tract found in the ventral horns of the spinal cord are biased toward __________ activity.
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extensor
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What are the four fundamental anatomical parts of a spinal cord reflex?
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1. Receptor Organs on distal end of a sensory organ
2. Afferent sensory neuron with receptor at distal end. 3. An efferent motor neuron with an effector organ at its distal end. 4. An effector organ |
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To break the a spinal cord reflex, which fundamental anatomical parts must be involved?
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Receptor organ on either afferent sensory neuron or efferent motor neuron, afferent sensory neuron, or efferent motor neuron
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What are flexor reflexes (protective reflexives) activated by?
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Type III (A-delta) & IV (C fibers)
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When you step on a tack, what pulls your foot up?
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Flexor reflexes involving Type III and Type IV fibers
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What causes a DTR/ myotactic/stretch reflex?
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The contraction of agonistic and synergistic muscles following the stretching of agonistic muscles.
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The DTR/myotactic/stretch reflex activates what fiber type(s)?
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Type Ia
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What path does the DTR/myotactic/stretch reflex take?
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Travel to dorsal root to then synapse w/LMN that returns to same muscle that was stretched
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What is the purpose of the DTR/myotactic/stretch reflex?
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It maintains upright posture and muscle tone.
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How does the DTR/myotactic/stretch reflex move thru the system?
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Gravity pulls on skeletal muscles then causes them to stretch then activates sensory neurons then go back to spinal cord then synapses with LMN then goes back out then causes the skeletal muscle to contract
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True or False
Partial muscle contraction allows us to maintain posture and muscle tone. |
True
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DTR/myotactic/ stretch reflex use 1st order sensory neurons with what type of receptor organs?
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Muscle spindle fibers
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Is the DTR/myotactic stretch reflex considered a proprioceptive reflex?
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Yes,because it involves skeletal muscles
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Is the DTR/myotactic/stretch reflex a 2 or more neuron pathway?
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It is a two neuron pathway
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The DTR/myotactic/stretch reflex is a 2 neuron pathway involving what?
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Receptor organs and Synapses
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What structures allows the muscle spindle fibers to measure length and rate of change of length?
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Extrafusal fibers
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What are the cells in the muscle spindle fibers called?
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Intrafusal fibers
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Are intrafusal fibers modified extrafusal fibers?
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yes
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What are the three types of intrafusal fibers?
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1. Dynamic Nuclear Bag (Ia) (most important)
2. Static Nuclear Bag(II) 3. Nuclear Chain Fiber(II) |
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True or False
All of the intrafusal fiber types function to differentiate between static and dynamic change in length and rate of change in length of skeletal muscle (extrafusal fibers) |
True
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Are intrafusal fibers parallel or perpendicular to extrafusal fibers?
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Parallel
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Are intrafusal fibers mechanical stretch receptors?
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Yes because they measure stretch
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Where are the noncontractile portions of the intrafusal fibers found?
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Located in the middle of the intrafusal fiber
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What does the annulospiral ending do and where is it found?
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Distal end of the intrafusal fiber that is wrapped around the noncontractile portion
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What is the primary sensory ending in the skeletal structure?
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Annulospiral ending
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What type of energy registers the length or rate of change of length in the intrafusal fiber in the annulospiral ending?
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Mechanical Energy
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Where are the flower spray endings located?
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Located laterally on either side of the annulosprial ending on the noncontractile portion of the intrafusal fibers.
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What Type of fibers are flower spray endings?
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Type II Sensory Neurons
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Type Ia fibers (annulospiral endings) monosynaptically (synapses 1 times)synapse in spinal cord with alpha motor neuron which innervate the same muscles (homonymous) or synergistic muscle (heteronymous).
True or False |
True
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Type II fibers (flower spray ending) only synapse (monosynaptically) with alpha motor neuron of the same muscle (homonymous).
True or False |
True
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What type of reflex causes autogenic inhibition?
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GTO Reflex/inverse reflex/tendon reflex.
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Encapsulated mechanoreceptors at the junction between muscle fibers and tendons are called
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Golgi Tendon Organs
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Are Golgi Tendon Organs involved with GTO Reflexes?
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Yes
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What are the efferent components of the DTR/myotactic/stretch reflex?
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Alpha Motor Neurons (LMN)
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Where are the cell bodies of the Alpha Motor Neurons?
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Ventral Horns
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What do the alpha motor neurons innervate?
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Extrafusal fibers - contraction of muscle can either produce movement or increase muscle tone
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What type of cells get inhibition of antagonistic muscle activity and what is this called?
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- Renshaw cells
- Reciprocal Inhibition |
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Is the GTO reflex/inverse reflex/tendon reflex considered proprioceptive reflex, why or why not?
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Yes because it involves muscles and tendons
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What type of fiber are GTO reflex/inverse reflex/tendon reflex?
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Type Ib
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What does the GTO reflex/inverse reflex/tendon reflex measure?
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It measures tension and rate of change of tension in the tendon.
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What is the major function of GTO reflex/inverse reflex/tendon reflex?
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Adjust muscle activitiy in concert with information from muscle spindle and descending controls.
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How does the GTO reflex/inverse reflex/tendon reflex prevent tearing of the muscles with extreme muscle contraction?
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Inhibits the contraction of the muscle, keeping the antagonistic muscle from being excessively stretched or contracted. Type Ib synapse with Renshaw cells to inhibit alpha motor neuron activity
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Can the GTO reflex/inverse reflex/tendon reflex cause a loss of muscle tone and function?
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Yes; autogenic inhibition=automatic inhibition
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What three primary factors affect muscle tone?
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1. Intrinsic characteristic of extrafusal fibers.
2. Gravity pulling on skeletal muscle and activating stretch reflex 3. Gamma bias due to supraspinal descending pathways influencing what gamma motor neurons are doing. |
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What do gamma motor neurons do?
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Alter the sensitivity of the muscle spindle by altering the length of the intrafusal fibers and the tension they exert.
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Are gamma motor neurons larger or smaller than alpha motor neurons?
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Smaller
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What cranial nerves can cause diplopia and what is it?
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CN III, IV, & XI
Double vision caused by paralyses of the extrinsic eye muscles |
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What cranial nerves can be involved with strabismus and what is it?
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CN III, IV, XI
Eyes are crossed and not synchronized during movement due to extrinsic eye muscles not properly innervated or muscle damage |
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What is mydriasis and why does it happen?
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A dilated pupil due to loss of preganglionic parasympathetic fibers in CN III (loss of input to iris in the Edinger-Westphal Nucleus)
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What is anisocoria and why does it happen?
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Pupils of unequal size due to one iris being innervated and one not due to loss of preganglionic parasympathetic fibers of CN III
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Is mydriasis found in the dilated eye?
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Yes
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If you shine a light in right eye and do not get a direct reflex in right eye but get consensus reflex in left eye, what is possibly happening?
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CN II of right eye is in tact and sending sensory info
Assume Right CN III is not working |
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Shine a light in left eye and do not get direct or consensus reflex, what is happening?
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Left CN II is not working
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What physical sign results in double vision due to paralysis of extrinsic eye muscles?
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Diplopia
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What physical sign of LMN paralysis to CN III that causes drooping of upper eyelid because of dysfunction of what muscle?
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Ptosis; levator palpebrae superioris
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Trochlear CN synapses as a LMN with what and where?
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UMN of the corticobulbar tract in the Trochlear motor nucleus in the midbrain
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What CN is involved with paralysis of the superior oblique extrinsic eye muscle?
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Trochlear CN IV
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What are three branches of trigeminal nerve and are they motor, sensory, or mixed?
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V1-sensory (opthalmic)
V2-sensory (maxillary) V3-mixed (mandibular) |
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Where and with what do the LMN of V3 synapse with?
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Motor Nucleus of V in tegmentum of pons(decussates); UMN in corticobulbar tract
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What nucleus does the abducens cell bodies originate in and what does it innervate?
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Abducens motor nucleus; lateral rectus extrinsic eye muscle
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Can either or both diplopia and adducted eye happen with damage to LMN of CN VI
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They can both happen
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What are the two sensory functions of Facial CN?
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1. Chorda tympani nerve innervates the anterior 2/3 of tongue for taste
2. Posterior auricular nerve innervatges the external ear for general sensations |
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What are the two motor functions of Facial CN?
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1. Innervates muscles of facial expression
2. Innervates Submandibular, Sublingual, and Lacrimal glands |
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The motor portion of the CN VII that innervates muscles of facial expression are divided into upper and lower portions. Which portion is has bilateral and which has unilateral synapse with the corticobulbar tract and in what nucleus and where?
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Upper has BL UMN Corticobulbar Tract.
Lower has UL UMN Corticobulbar Tract Both synapse the Facial Motor Nuclei in the Pons. |
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Upper portion of CN VII that synapses with UMN in Facial Motor Nuclei innervates what?
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Innervates muscles above horizontal line of the eye orbit.
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Lower portion of CN VII that synapses with UMN in Facial Motor Nuclei innervates what?
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Innervates muscles below horizontal line of the eye orbit.
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The portion of CN VII that innervates the submandibular, sublingual, and lacrimal glands is involved with sympathetic or parasympathetic nervous system?
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Parasympathetic of ANS
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The motor portion of CN VII that innervates the submandibular, sublingual, and lacrimal glands is controlled by what?
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Either Reflex or Hypothalamus
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Where are the preganglionic parasympathetic neurons for motor portion of CN VII located?
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Salivatory Nuclei in Tegmentum of Medulla
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Where do the pre and post parasympathetic neurons synapse that innervate the submandibular and sublingual glands in CN VII?
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Submandibular Ganglia
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Where do the pre and post parasympathetic neurons synapse that innervate the lacrimal gland in CN VII?
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Pterygopalantine Ganglia
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Lesion in CN VII can cause?
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1. Bell's Palsey
2. Loss of Tearing 3. Loss of Salivation 4. Loss of Taste Perception to the anterior 2/3 of tongue |
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In relation to CN VII, are LMN Paralysis, Loss of Tearing, Loss of Salivation, and Loss of Taste Perception contralateral or ipsilateral?
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All Ipsilateral
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The Vestibulochochlear Nerve is made up of what two nerves and were do they originate?
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1. Auditory Nerve - Organ of Corti
2. Vestibular Nerve - Semicircular Canals |
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What are the two possible results from lesions with CN VIII and are they ipsilateral or contralateral?
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1. Loss of hearing (auditory nerve)- ipsilateral
2. Loss of Equilibrium Input (vestibular nerve) - ipsilateral |
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What are the two motor functions fo the Glossopharyngeal Nerve?
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1. Innervates the stylopharyngus muscle of pharynx
2. Innervates the parotid gland (parasympathetic) |
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What nuclei do the UMN and LMN of CN IX synapse in and what muscle does it innervate?
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Nucleus Ambiguous of Tegmentum of Medulla; Stylopharyngus Muscle
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Where do the preganglionic parasympathetic neurons for CN IX orginiate and where do they synpase with postganglionic?
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Salivatory Nuclei in Tegmentum of Medulla; Synapse in Otic Ganglia in the neck
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Loss of general sensation in posterior 1/3 of tongue is a result of damage to CN?
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CN IX
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Loss of taste perception to posterior 1/3 of tongue results from damage to CN?
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CN IX
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Ipsilateral loss of gag reflex results from damage to CN?
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CN IX
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Ipsilateral loss of palatal and uvular reflexes results of damage to CN?
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CN IX
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Dimished carotid sinue and carotid body receptors results of damage to CN?
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CN IX
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Dysphagia (difficulty swallowing) results of damage to CN?
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CN IX & X
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Ipsilateral loss of salivation from loss of preganglionic parasympathetic neurons that innervate the parotid gland results in CN?
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CN IX
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What are the two motor functions of the Vegus Nerve?
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1. Innervates muscles of larynx, pharynx, and soft palate
2. Innervates viscera of thoracic and abdominal as low as left colic flexure (parasympathetic ANS) |
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What is the longest nerve in the body?
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Vegus Nerve
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What CN is a part of the General Visceral Afferent System because it innervates visceral structures of thorax and abdomin?
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Vegus Nerve
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For CN X, where do the UMN and LMN synapse before innervating the larynx, pharynx, and soft palate?
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Nucleus Ambiguous in Tegmentum of Medulla
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Where do the preganglionic parasympathetic neurons orginate and where do they synapse with post in CN X?
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Orginates in Dorsal Motor Nucleus of the Tegmentum of the Medulla; Synapses in numerous ganglia near where the organ to be innervated is...
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What six problems can arise from damage of CN X?
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1. LMN paralysis to ipsilateral soft palate
2. Dysphagia (difficulty swallowing? 3. LMN paralysis of laryngeal muscles 4. Loss of Gag reflex 5. Loss of palatal uvular reflexes 6. Transient Tachycardia (increased heart rate) |
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Why is the Spinal Accessory Nerve unique?
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Because it has to portions: cranial & cervical (spinal)
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Does the corticobulbar UMN synapse with both the cranial and cervical portions of CN XI? If yes, where?
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Cranial portion does in the Nucleus Ambiguous in the Tegmentum of Midbrain.
Cervical portion does also in the Spinal Motor Nucleus in Cervical Portion of the Spinal Cord. |
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Where does the Cervical Portion of CN XI exit the brainstem?
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It exists laterally thru the Inferior Olive in the Medulla.
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Do the two portions become the spinal accessory nerve before or after it passes thru the Jugular Foramen?
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Before it passes the Foramen.
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What muscles are innervated by the cranial portion of CN XI and what nerve joins it to innervate those muscles?
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Innervates larynx, pharynx, and soft palate. CN XI and CN X join to innervate.
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What muscles are innervated by Cervical portion of CN XI
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SCM and Trapezius
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What area does the Cervical portion of CN XI pass thru to get to the trapezius?
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Posterior Triangle in the neck
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What CN could be damaged if the patient can not look over there shoulder(lateral rotation)?
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LMN paralysis of CN XI
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What CN could be damaged if the patients shoulder is downwardly and outwardly rotated?
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LMN paralysis of CN XI
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Are spinal cord reflexes found in white or grey matter?
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Grey matter
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Major function of GTO reflex?
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Adjust muscle activity
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What does the GTO reflex prevent?
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With extreme muscle contraction the gto can Prevent tearing of muscles by inhibiting the contraction of the muscle.
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How does an Achilles tendon end up tearing if GTO is supposed to prevent that?
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Sometimes the GTO doesn't have time to respond.
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What 3 primary factors determine muscle tone?
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1. Intrinsic characteristics of extrafusal fibers
2. Gravity pulling on skeletal muscles and activating stretch reflexes 3. Gamma bias (supra spinal descending pathways influencing what gamma motor neurons are doing |
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What is the function of gamma motor neurons?
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They alter the sensitivity of the muscle spindle by altering the length of the intrafusal fibers and the tension they exert.
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Hypotonia results from what three things?
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1. Removing LMN (alpha and gamma)
2. Eliminated the afferent limb 3. Lesions of the cerebellum involved with gamma bias |
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What type of hypertonia results from hyperreflexia of deep tendon reflexes (dtr)?
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Spasticity
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What type of hypertonia results from an increase in tone in all muscles although the strength and reflexes are not affected?
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Rigidity
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Does the cerebellum directly or indirectly project to the ventral spinal horn?
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Indirectly
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What are the three functions of the cerebellum?
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1. Coordinate voluntary muscle activity
2. Coordinate equilibrium activity 3. Influence muscle tone |
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Refers to the changes that occur in the orgainization of the brain, and in particular changes that occur to the location of specific information processing functions, as a result of the effect of learning and experience.
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Neuroplasticity
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The pattern of functional and structural changes in responses to environmental physiological or pathological events.
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Neuroplasticity
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Refers to the brain's ability to change structure and function.
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Neuroplasticity
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True or False
Brain plasticity may account for the retun of function to speech, language, motor function, and/or sensory function after a stroke. |
True
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True or False
Neurons make new connections after a period of time after injury due to neuroplasticity. |
True
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Is phantom limb/pain an example of neuroplasticity?
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Yes, it gives a false representation.
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Does neuroplasticity affect both sides (injured and uninjured) when setting up new systems?
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Yes it does. Bilateral rehabilitation issues meaning setting up new systems on both sides.
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What are the four stimulants for neuroplasticity?
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1. Loss or modified afferent input to the CNS
2. Damage to the CNS 3. Chemical Stimulations (drugs) .4. Environmental or training stimulation |
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There are many theories for neural plasticity, but which one is most important?
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Structural changes (anatomical changes)
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Stem Cell Activation, Sparing (Remaining Cells Becoming More Active), Redundancy of Systems, Unmasking Secondary Areas, and Structural Changes are all theories for what?
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Neuroplasticity
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What happens during structural changes in neuroplasticity?
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- Increases in synapses
- Modification of synapses - Increase in dendrites (dendritic sprouting to increase surface area) - Dendritic and axonal remodeling |
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How does increasing in dendrites affect neuroplasticity?
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The dendric sprouting increases surface area to enhance connection when others have been lost
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True or False
Compensation is a form of the neuroplasticity mechanism. |
False! A distinction needs to be made between neuroplasticity mechanism at work and the ability of the organism to compensate.
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Is neural plasticity only a pathological process?
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Nope otherwise we wouldn't be able to learn new tasks like playing the violin (Research supports this)
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What influences neural plasticity?
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Environmental Stimuli
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In regards to neural plasticity, are complex or simple environmental stimuli better?
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Complex is better - read out loud instead of to yourself
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True or False
Neural Plasticity is not age dependent. |
False - It becomes less effective as age increases
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Is neural plasticity more effective immediatly following injury or with more time in between?
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Most effective immediately following CNS insult (Window of Opportunity)
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True or False
Nothing is done in isolation in regards to sides in the CNS. |
True
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What is the anterior lobe of the cerebellum responsible for?
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1. Maintains muscle tone
2. Maintenance of posture 3. Gross voluntary movement (gait) |
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|
What happens during structural changes in neuroplasticity?
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- Increases in synapses
- Modification of synapses - Increase in dendrites (dendritic sprouting to increase surface area) - Dendritic and axonal remodeling |
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How does increasing in dendrites affect neuroplasticity?
|
The dendric sprouting increases surface area to enhance connection when others have been lost
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|
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True or False
Compensation is a form of the neuroplasticity mechanism. |
False! A distinction needs to be made between neuroplasticity mechanism at work and the ability of the organism to compensate.
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Is neural plasticity only a pathological process?
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Nope otherwise we wouldn't be able to learn new tasks like playing the violin (Research supports this)
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What influences neural plasticity?
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Environmental Stimuli
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In regards to neural plasticity, are complex or simple environmental stimuli better?
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Complex is better - read out loud instead of to yourself
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True or False
Neural Plasticity is not age dependent. |
False - It becomes less effective as age increases
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Is neural plasticity more effective immediatly following injury or with more time in between?
|
Most effective immediately following CNS insult (Window of Opportunity)
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True or False
Nothing is done in isolation in regards to sides in the CNS. |
True
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What is the anterior lobe of the cerebellum responsible for?
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1. Maintains muscle tone
2. Maintenance of posture 3. Gross voluntary movement (gait) |
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What is the posterior lobe of the cerebellum responsible for?
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Coordination of fine voluntary movement
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What is the flocculonodular lobe of the cerebellum responsible for?
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Maintenance of equilibrium
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A classical cerebellar symptom is?
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General Ataxia
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Abnormality in muscular coordination leading to abnormality of voluntary movement.
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General Ataxia
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What are signs of ataxia in the anterior lobe of the cerebellum?
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- Muscles contract weakly and irrecgulary
- Unsteady or drunken gait - Feet spaced far apart to stablize - Lean or lurch to affected side |
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What are signs of ataxia in the posterior lobe of the cerebellum?
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-Intentional tremor/terminal tremor
- Dysmetria (inability to stop a muscle movement at a desired point) - Dyssynergia (voluntary movements are jerky and tremor like - Dysdiadokinesia(inability to perform rapid & alternating movements - dysarthria (slurred or hesitant type of speech) |
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Is hypotonia a possible sign of damage to the anterior lobe of the cerebellum?
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Yes, influences gamma bias
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Is nystagmus a possible sign of damage to the flocculonodular lobe of the cerebellum?
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Yes
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Is basal ganglia a part of the pyramidal or extrapyramidal system?
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Extrapyramidal System
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Where is the basal ganglia found?
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Deep seated within white matter of cerebral hemispheres.
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What is the posterior lobe of the cerebellum responsible for?
|
Coordination of fine voluntary movement
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What is the flocculonodular lobe of the cerebellum responsible for?
|
Maintenance of equilibrium
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|
|
A classical cerebellar symptom is?
|
General Ataxia
|
|
|
Abnormality in muscular coordination leading to abnormality of voluntary movement.
|
General Ataxia
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|
|
What are signs of ataxia in the anterior lobe of the cerebellum?
|
- Muscles contract weakly and irrecgulary
- Unsteady or drunken gait - Feet spaced far apart to stablize - Lean or lurch to affected side |
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|
What are signs of ataxia in the posterior lobe of the cerebellum?
|
-Intentional tremor/terminal tremor
- Dysmetria (inability to stop a muscle movement at a desired point) - Dyssynergia (voluntary movements are jerky and tremor like - Dysdiadokinesia(inability to perform rapid & alternating movements - dysarthria (slurred or hesitant type of speech) |
|
|
Is hypotonia a possible sign of damage to the anterior lobe of the cerebellum?
|
Yes, influences gamma bias
|
|
|
Is nystagmus a possible sign of damage to the flocculonodular lobe of the cerebellum?
|
Yes
|
|
|
Is basal ganglia a part of the pyramidal or extrapyramidal system?
|
Extrapyramidal System
|
|
|
Where is the basal ganglia found?
|
Deep seated within white matter of cerebral hemispheres.
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|
What are the three basal ganglias?
|
1. Caudate Nucleus
2. Putamen 3. Globus Pallidus |
|
|
What forms the extrapyramidal system?
|
3 basal ganglia, red nucleus, substantia nigra, and subthalamic nucleus
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|
Does the basal ganglia have a direct or indirect relationship with LMNs?
|
Indirect
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|
How does the basal ganglia influence the reticulospinal tract?
|
The basal ganglia sends info to the reticular formation which goes to the ventral horms
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|
How does the basal ganglia influence the corticospinal tract?
|
Basal ganglial sends info to pre-central gyrus to influence UMN
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How does the basal ganglia influence the nigroreticular tract?
|
Basal ganglia sends info to substantia nigra in the midbrain which goes to reticular formation and ends up tin the reticulospinal tract
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How does the basal ganglia influence the thalamocortical tract?
|
Basal ganglia sends info to thalamus which then sends info to cortex thru thalamocortical tract.
|
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|
Can the pyramidal and extrapyramidal systems work alone?
|
Nope They are intimately integrated
|
|
|
Does the basal ganglia assist in inhibiting co-contraction of antagonistic muscles of the limbs?
|
Yes
|
|
|
Does the basal ganglia assist in adjusting body position during movement for a specific task?
|
Yes
|
|
|
Does the basal ganglia work on a subconcious or reflex level?
|
Yes it does
|
|
|
Reducttion in the initian, implementation,and facilitation of execution of movement.
|
Hypokinesia
|
|
|
What characteristics are common with basal ganglia damage?
|
- Hypokinesia
- Symptoms associated with Parkinson's Disease |
|
|
What are two descriptions of hypokinesia?
|
- Hypertonia
- Rigidity |
|
|
Define cogwheel rigidity
|
Rigidity with increased jerky resistance for PROM (increase in muscle tone)
|
|
|
Define Plastic Rigidity
|
Rigidity with increased resistance to PROM that is constant, continuous and smooth (lead pipe)
|
|
|
What are some symptons of Parkinson's Disease?
|
1. Concious movement may be suppressed with hypokinesia
2. Abnormal postures assumed 3. Arm swing during gait is absent. 4. DTR are usually normally 5. Facial expression may be masked. |
|
|
What's happening with the pathology of Parkinson's Disease?
|
- Degeneration of substantia nigra of midbrain
- Decreased amounts of neurons leads to a dopamine-depleted basal ganglia(decreased dopamine=decreased inhibition) - Disinhibition (Basal ganglia cannot be inhibited & will do things in an uncontrolled manner |
|
|
What is the disinhibition phenomenon?
|
Involuntary movement because basal ganglia is no longer inhibiting the movement
|
|
|
What are four involuntary movements associated with basal ganglia damage?
|
1. Static Tremor / Alternating Tremor
2. Athetosis 3. Chorea 4. Ballism |
|
|
What is the hallmark of basal ganglia dysfunction?
|
Static tremor
|
|
|
Pin rolling (alternating tremor) is and is located in what nucleus?
|
Involuntary movement and is supressed when intentional skilled muscle activity; Caudate Nucleus
|
|
|
Involuntary movement characterized by slow, writhing, worm-like movements of the fingers. What part of basal ganglia involved?
|
Athetosis; Putamen
|
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|
Sudden, involuntary, jerky movements along with grimacing or twitching of facial muscles and faulty vocalization. What basal ganglia involved?
|
Chorea; Caudate Nucleus
|
|
|
Involuntary movements of an entire limb; begins proximally and proceeds distally like a wave; may involve one or more extremity of the same side.
|
Ballism
|
|
|
Is ballism indicative of a subthalamic stroke?
|
Yes
|
|
|
What are the excitatory neurotransmitters and neuromodulators?
|
- ACh
- Glutamate - Aspartate |
|
|
Inhibitory neurotransmitters and neuromodulators for the basal ganglia?
|
- GABA
- Dopamine - Glycine |
